Sometimes the eyelids can become incorrectly positioned. With entropion, the eyelid has turned inward. With ectropion, the eyelid has turned outward. The usual culprit behind these eye conditions is the simple slackening of muscles, tendons, and connective tissues that is part of normal aging. At Longwood Eye & LASIK Center, our surgeons usually treat entropion and ectropion with surgery.
What Is Entropion?
When a person has entropion, his or her eyelid has turned inward. This usually affects the lower eyelid and causes the skin and eyelashes to painfully rub against the cornea. In some cases, the eyelid is rolled inward continually; in other cases, it occurs only when the eyelids are closed tightly.
What Causes Entropion?
Entropion is usually a result of aging, as the muscles around the eyes become weaker. For this inward-turned eyelid, these are the potential causes:
- Muscle weakness
- Congenital defect
- Prior eyelid surgery
- Skin disease
What Are the Symptoms and Complications of Entropion?
Symptoms are eye pain, redness, irritation, dry eyes, excessive tearing, sensitivity to light, reduced vision, discharge from the eye, and a feeling that there is something in the eye. If left untreated, entropion can lead to corneal abrasions, ulcers, and infections.
What Is Ectropion?
Ectropion is the opposite of entropion — here the eyelid turns outward. This also typically affects the lower eyelid and can impact the entire lower lid or just a part of it.
What Causes Ectropion?
- Muscle and connective tissue weakness
- Eyelid growths
- Previous eyelid surgery
- Facial scarring from burns or trauma
- Excessive sun exposure
- Cosmetic laser skin resurfacing
- Facial paralysis due to Bell’s palsy
- Radiation of the eyelid to treat cancer
- Use of certain eye drops for glaucoma
What Are the Symptoms of Ectropion?
Ectropion inhibits proper drainage of tears in the eye. Because of this, it causes eye irritation and redness, excessive tearing, pain, sensitivity to light, inflammation, and a gritty feeling in the eyes. Although less frequent than with entropion, untreated ectropion can lead to corneal abrasions, ulcers, and eye infections.
How Common Are Entropion and Ectropion?
Unless congenital or the result of former cosmetic eyelid surgery, both ectropion and entropion are usually simply due to weakening of the muscles, tendons, and connective tissue of the eyelids that come with aging. These eyelid conditions aren’t common, affecting around 2 percent of the elderly population with entropion and 3 percent with ectropion.
Who Is at Risk for Developing Entropion or Ectropion?
If not congenital, these conditions have certain risk factors for development:
- Age — The older you are, the greater your chances of having these eyelid issues.
- Previous burns or trauma — If you’ve had an injury or burn on your face, the scar tissue that may have formed can impact your eyelid function.
- Trachoma infection — If you’ve had this rare infection, it can scar the inner eyelids.
How Are Entropion and Ectropion Commonly Treated?
Botox injections have shown some promise for relaxing the muscles that lead to inward rolling of the eyelid. But most other treatments are temporary and only meant as short-term soothing options to relieve redness and irritation of the eyes.
The only real treatment is surgery. We perform these procedures, sometimes known as tarsorrhaphy (although this is usually meant for surgery of more involved eyelid problems), as an outpatient procedure at Longwood Eye & LASIK Center.
For entropion, a small section of the eyelid is removed to tighten the muscles in the area. If the problem is tied to scar tissue or due to prior eyelid surgery, a skin graft may be used to reposition the eyelid.
For ectropion, the surgery may involve stretching of scar tissue or similar options to what is done for entropion.
What Is Recovery like After These Surgeries and Are There Side Effects?
After entropion or ectropion surgery, we may place you in an eye patch for the first 24 hours. Your eyelid may feel tight for a few days after the procedure. This will calm as it heals. We’ll give you an antibiotic and steroid ointment that you use on your eye several times a day for the first week. Your stitches will come out after about one week. You’ll have some bruising and swelling that can last for about two weeks. The diligent use of a cold compress will help with this. Generally, this is a very successful surgery and recovery is not that difficult.
The main side effect or complication is that the surgery won’t entirely correct the problem, and you may have to have a follow-up procedure. This is very rare, however.
What Happens If I Don’t Treat My Entropion or Ectropion?
These aren’t conditions to “manage” with eye drops and the like. Both entropion and ectropion cause irritation of the cornea that can result in abrasions and ulcers. If left untreated, these can lead to permanent vision damage.